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/� �Plicat�on For Dat� <br /> F PUBLIC 1►�ORKS PERMIT <br /> PUBLIC WORKS DEPARTMENT public Works permR M <br /> 3200 Cedar Street <br /> Everett,Wq 98201 259-8870 <br /> Bulding Permft M <br /> iYPE OR PRINT ONLY Public Works Fea S <br /> Plan Check No: C 60486 SEPA <br /> Applicat.Date: 10�13/98 <br /> Owner Job Addreee: 38 3 COLBY AVE <br /> Owner: CHURCH PATTY Phone <br /> Tenant: <br /> Propoeed Uee: DUPLEX <br /> Deec. of Work: <br /> App6cant REHODEL BASEMENT TO CREATE LIVING <br /> UNIT/REHODEL NAIN FLOOR Phcna <br /> Describe PropOsed Wofk_ OFFICE SET JOB SET <br /> APPROVED FOR PERHIT: DATE_/_/_ gY W <br /> ■ <br /> '�w <br /> PROJECT ADDRESS (if known) —I <br /> Attach four(4)copies ol p�ans for proposed work-Draw to scale and note tha lollowing if applicable: � <br /> •Property IJnes 'Outtine and dimensions of all existing and proposed strvctures on the lot •Existing and proposed utilRies O <br /> •Centerline o(street •Indlcate Nonh •Show any proposed grading changes •Show measurements <br /> DO NOT WRITE BELOW THIS LINE � <br /> PERMIT CONDITIONS: � <br /> 1.All calls for inspection shall be made 24 hours in advance-phone 259-8810. • <br /> 2. All work shall be performed in accordance with this permit and cunent City of Everett Design and O <br /> Construction Standards and Specifications. <br /> 3. Call Location Underground Service 4B hrs. before you dig. TOLL FFEE NUMBER 1-800-424-5555. <br /> � <br /> P{� ��rM�-� ✓iot �e�v;red• � <br /> � <br /> ���� <br /> a <br /> ACKNOWLEDGEMENT OF CONDITIONS <br /> The undersigned owner/applicant hereby agrees to hold and save harmiess <br />� the City ol Everett from any and all claims for damages,costs,expenses,or <br /> Approved for ConsWction Date eauses ot action that may arise because of installatlon and maintenance of <br /> ihe impmvement or other right-cl-way use hereto applied lor and further agrees <br /> to removesame upon notice irom the City and to rep�ace public property <br /> damaged thereby. <br /> FINAL INSPEC110N Date <br /> Approved as Constructed <br /> Signature of Applicant Date <br /> WORK AUTHOR2E0 BY hI1S PERMI7 MUST BE STARTED WITHIN 1B0 DAYS OF DATE PERMIT IS ISSUED AND 7HEREAFTER IS TO BE DILIGENTLY PURSUED TO <br /> COMPLEf10N,iHIS PERMIT MAY BE CANCELLED BY THE CfTY UPON ANY STOPPAGE OF WORK ON hIIS PROJECT OVER 90 DAYS DURATION. <br />